SELF/Perioperative Nursing/Surgical Assistance/Psychomotor Skills Practice Assessment

Psychomotor Assessment Rubric for First Surgical Assistance (ECSACONM)

Overview

This page provides a psychomotor assessment rubric for evaluating first surgical assistance competency, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It is a companion assessment tool to the Surgical First Assistant Skills Practice Instructions page, used by evaluators to rate student/practitioner performance on each step of first assisting on a 5-point scale.

Purpose

To provide a standardized scoring framework for assessing clinical competency in first surgical assistance, ranging from "Clinically Unacceptable / Not Performed" (1) to "Excellent" (5), with defined criteria at each anchor point.

Rating Scale

1 – Clinically Unacceptable / Not Performed
2 – (between 1 and 3, no separate descriptor)
3 – Clinically Acceptable / Performed
4 – (between 3 and 5, no separate descriptor)
5 – Excellent

Assessment Rubric

Step	Name	Assessment Method	1 – Clinically Unacceptable / Not Performed	3 – Clinically Acceptable / Performed	5 – Excellent
1	Gather supplies	Articulated	Not done	Done
2	Perform hand hygiene and don PPE	Articulated	Not done	Done
3	Assist with initial exposure of the surgical site and suctioning	Observed	Applies unsafe retraction or suction, causes tissue trauma, loses exposure, or requires continuous prompting	Maintains adequate exposure using safe retraction and controlled suction with occasional prompting	Maintains excellent exposure independently, anticipates adjustments, protects tissues, and responds immediately to changing surgical conditions
4	Maintain surgical site visibility throughout	Observed	Frequently loses visualization, applies inappropriate retraction, or fails to respond to changing operative conditions	Maintains visualization with appropriate retraction and suction throughout most of the procedure	Continuously anticipates visualization needs, makes smooth adjustments, and maintains an optimal operative field without prompting
5	Handle and pass instruments and supplies	Observed	Frequently passes incorrect instruments, delays delivery, compromises safety, or presents instruments incorrectly	Passes the correct instruments safely and in appropriate orientation with occasional prompting	Consistently anticipates instrument requirements, presents instruments confidently, safely, and efficiently without prompting
6	Assist with tissue manipulation and haemostasis	Observed	Handles tissues roughly, delays assistance, or fails to support haemostasis appropriately	Handles tissues gently, provides haemostatic assistance appropriately, and follows surgeon instructions	Demonstrates consistently atraumatic tissue handling while anticipating haemostatic needs and supporting surgical flow efficiently
7	Apply appropriate retraction force	Observed	Applies excessive or inadequate force causing tissue stress or poor exposure	Maintains appropriate retraction force while protecting surrounding tissues	Continuously adjusts retraction according to tissue response, maintaining excellent exposure while minimizing tissue trauma
8	Pad and protect pressure points	Observed	Fails to protect vulnerable tissues or neglects prolonged pressure areas	Protects vulnerable tissues appropriately and reassesses padding periodically	Consistently anticipates vulnerable structures, maintains effective padding throughout, and prevents tissue compression independently
9	Angle retractors along tissue planes	Observed	Positions retractors incorrectly, creating tissue distortion or unstable exposure	Positions retractors appropriately along natural tissue planes	Demonstrates excellent anatomical awareness, maintaining optimal exposure with minimal tissue distortion throughout the procedure
10	Adjust retractors frequently	Observed	Maintains prolonged static retraction despite tissue compression or poor exposure	Repositions retractors appropriately during prolonged procedures	Continuously reassesses tissue condition and proactively redistributes retraction pressure without compromising exposure
11	Monitor the operative field and anticipate needs	Articulated	Not done	Done
12	Support surgical count	Articulated	Not done	Done
13	Manage sutures, needles, and surgical materials	Observed	Loads needles incorrectly, handles sharps unsafely, or fails to maintain appropriate suture tension	Safely manages sutures, needles, and sharps while maintaining appropriate tension and organization	Demonstrates consistently smooth, efficient suture management while anticipating surgeon requirements and maintaining excellent sharps safety
14	Cut sutures or tie knots as directed	Observed	Cuts incorrect suture, damages knot, or cuts at inappropriate length or timing	Cuts the correct suture safely while preserving knot integrity	Demonstrates precise timing, correct strand identification, and consistently accurate suture cutting throughout closure
15	Assist with wound closure if directed	Observed	Provides poor exposure, delays assistance, or compromises wound approximation	Supports wound closure appropriately while maintaining exposure and providing required materials	Demonstrates seamless wound closure assistance by anticipating surgeon needs, maintaining exposure, protecting tissues, and facilitating efficient closure

Page data
Keywords	surgery, health
SDG	SDG03 Good health and well-being
Authors	Ian-laurel
License	CC-BY-SA-4.0
Organizations	SELF, ECSACONM
Language	English (en)
Related	0 subpages, 1 pages link here
Views	0 page views (analytics)
Created	July 13, 2026 by 2607:FEA8:3441:6400:9DB7:3F82:7765:2223
Last edit	July 14, 2026 by 2607:FEA8:3441:6400:9DB7:3F82:7765:2223
Cite as	"SELF/Perioperative Nursing/Surgical Assistance/Psychomotor Skills Practice Assessment". Appropedia. 2026. Retrieved July 14, 2026.
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